Han Seung Hoon, Ji Jeong-Yeon, Cha Wonjae, Jeong Woo-Jin
Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea.
Department of Otorhinolaryngology-Head & Neck Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
Gland Surg. 2023 Jan 1;12(1):30-38. doi: 10.21037/gs-22-365. Epub 2022 Dec 17.
Remote-access robotic thyroid surgery enables avoiding a visible scar on the neck and allows precise manipulation through a magnified surgical view. The retroauricular approach has many advantages. This study aimed to evaluate the learning curve for robotic retroauricular thyroidectomy using cumulative sum analysis.
The medical records of 36 patients who underwent robotic retroauricular thyroidectomy between 2018 and 2021 were retrospectively reviewed. The clinical features and surgical outcomes were analyzed; the learning curve was evaluated using the cumulative sum analysis.
The learning curve using cumulative sum analysis was divided into two phases based on 15 cases: phase I (first 15 cases) and phase II (remaining 21 cases). The total operation time was significantly shorter in phase II than that in phase I (161.9±23.4 . 199±41.0 min, P=0.002). The flap dissection and docking time (77.1±14.3 . 90.0±21.5 min, P=0.037) and console time (36.5±16.2 . 50.3±17.8 min, P=0.020) were significantly shorter in phase II than that in phase I. There was no significant difference between the two phases in the total amount of drainage, duration of hospital stay, and complications after the surgery.
The learning curve for robotic retroauricular thyroidectomy demonstrates that the operation time decreased rapidly after 15 cases. Proficiency in docking and manipulating the instruments accelerate the learning curve.
远程接入机器人甲状腺手术能够避免颈部出现可见疤痕，并通过放大的手术视野实现精确操作。耳后入路有诸多优点。本研究旨在使用累积和分析评估机器人耳后甲状腺切除术的学习曲线。
回顾性分析2018年至2021年间接受机器人耳后甲状腺切除术的36例患者的病历。分析临床特征和手术结果；使用累积和分析评估学习曲线。
基于15例病例，使用累积和分析的学习曲线分为两个阶段：第一阶段（前15例）和第二阶段（其余21例）。第二阶段的总手术时间明显短于第一阶段（161.9±23.4对199±41.0分钟，P = 0.002）。第二阶段的皮瓣剥离和对接时间（77.1±14.3对90.0±21.5分钟，P = 0.037）和控制台操作时间（36.5±16.2对50.3±17.8分钟，P = 0.020）明显短于第一阶段。两阶段在术后总引流量、住院时间和并发症方面无显著差异。
机器人耳后甲状腺切除术的学习曲线表明，15例手术后手术时间迅速缩短。熟练掌握仪器对接和操作可加速学习曲线。
